Mitochondrial dysfunction, increased lipid peroxidation and altered catabolism will affect the cellular lipidome during cell senescence. Alterations in lipid metabolism and the generation of oxidised lipids may be beneficial for the senescent program during the early stages of senescence induction, possibly through modulating inflammatory and immune responses (Lawrence et al. 2002; van Diepen et al. 2013; Yaqoob 2003). However, if senescent cells persist in tissues, changes in lipid composition can result in cell dysfunction, altered rates of fatty acid oxidation that can induce inflammation and increased lipid peroxidation that can promote damage to neighbouring cells. These factors may contribute to ageing and age-related diseases. Research focused on altered lipid metabolism during cellular senescence, particularly regarding mitochondrial lipids, is in its infancy. However, in recent years, several studies have made progress in evaluating the senescent lipidome of fibroblasts.

One group investigated the alterations in a number of metabolites associated with the extracellular metabolome of fibroblasts induced to senesce via proliferative exhaustion or via γ-irradiation (James et al. 2015). They reported that a number of fatty acids and their precursors such as eicosapentaenoate, malonate, 7-alpha-hydroxy-3-oxo-4-cholestenoate and 1-stearoylglycerophosphoinositol were elevated during fibroblast senescence when compared with proliferating and quiescent cells, whereas linoleate, dihomo-linoleate, 10-heptadecenoate were depleted. Also amongst the secretory lipidome from senescent fibroblasts was an accumulation of monohydroxy fatty acids (2-hydroxypalmitate, 2-hydroxystearate, 3-hydroxydecanoate, 3-hydroxyoctanoate) and a phospholipid catabolite (glycerophosphorylcholine). It was suggested that whilst some of these changes may be due to oxidative stress, other observed increases may be a response to increased biomass commonly observed amongst senescent cells.

Maeda et al. (2009) investigated the regulation of fatty acid synthesis and ∆9-desaturation during cell senescence in human fibroblasts (Maeda et al. 2009). They found that the levels of fatty acid synthase and stearoyl-CoA desaturase-1 were decreased in senescent fibroblasts compared to proliferating fibroblasts, consequently leading to a decrease in monounsaturated fatty acids. In addition, reduced de novo synthesis of phospholipids with an associated increase in the formation of cholesterol in senescent cells was also observed and exogenous fatty acids were shown to be preferentially incorporated into the triacylglycerol pool of senescent cells.

In another study, the metabolic alterations associated with oncogene-induced senescence (OIS), using Ras-induced senescent human fibroblasts as a model were investigated (Quijano et al. 2012). Through the profiling of ~300 different intracellular metabolites, these authors showed that cells that have undergone OIS develop a metabolic signature which is distinct from cells which have undergone replicative senescence in response to extended in vitro cell culture. In the latter, a switch towards glycolysis has been observed that precedes the onset of senescence (Bittles and Harper 1984). In OIS, an increase in certain intracellular long chain fatty acids, including eicosanoate, dihomo-linoleate, mead acid and docosadienoate were observed. This altered metabolome was shown to associate with a decline in lipid synthesis and increases in fatty acid oxidation. Interestingly, the pro-inflammatory activity of the senescent secretome was reduced by inhibition of carnitine palmitoyltransferase 1, the rate limiting step in mitochondrial fatty acid oxidation, suggesting that alterations in lipid metabolism during OIS may play a role in regulating the pro-inflammatory senescent secretome. Although the mechanism underlying the increase in fatty acid levels during OIS were not fully explored, it may be due to promyelocytic leukemia (PML) activation of the fatty acid oxidation pathway through PPAR signalling (Aird and Zhang 2014). The differences between replicative senescence and OIS are intriguing; they may relate to the physiological need in preventing cancer to switch away from glycolysis as a rapid source of energy that is harnessed by cancer cells to enable them to proliferate rapidly versus the increasing insulin resistance that is seen in ageing and which associates with impaired oxidative metabolism (Burkart et al. 2016). However, while this and other studies have indicated an increase in glucose uptake during OIS, a number of other studies have observed either no change or a significant decrease in glucose uptake. This may relate to the timing of senescence induction, the cell type or the oncogene responsible.

A further study compared global lipid profiles and associated mRNA levels of proliferating and replicative senescent BJ fibroblasts; 19 specific polyunsaturated triacylglycerol species were identified as undergoing significant changes in lipid composition during cell senescence (Lizardo et al. 2017). In addition, significant changes in the expression of genes involved in specific lipid-related pathways, including glycerolipid metabolism, glycerophospholipid metabolism, unsaturated fatty acid synthesis and sphingolipid metabolism were observed during cell senescence. Based on these lipidomic and transcriptomic analysis, the authors postulated that activation of CD36-mediated fatty acid uptake and alteration to glycerolipid biosynthesis may contribute to the accumulation of triacylglycerols during cell senescence. It was suggested that these changes may be a mechanism to prevent lipotoxicity during elevated oxidative stress conditions during cell senescence.

In addition to an altered lipidome during cellular senescence, elevated ROS, likely from uncoupled mitochondria, can promote lipid peroxidation which potentiates cellular damage at distant sites. For example, stable aldehydes can diffuse from their site of generation and form adducts at distant locations, thereby propagating the responses and injury initiated by ROS (Ramana et al. 2013), including the induction of cell senescence in neighbouring cells. Flor and Kron observed an accumulation of lipid-derived aldehydes such as 4-hydroxy-2-nonenal (4-HNE) during accelerated senescence (Flor and Kron 2016). Whereas, the treatment of cells with either 4-HNE or low (5 Gy) γ-irradiation only generated low levels of cell senescence, combining both 4-HNE and 5 Gy γ-irradiation significantly elevated the senescence response. Furthermore, the use of the aldehyde-sequestering drug hydralazine blocked cell senescence induction by 25 Gy and etoposide treatment, demonstrating the potential importance of lipid peroxidation during therapy-induced senescence (Flor et al. 2016). Despite the highly damaging and pro-ageing potential of senescence-derived lipid peroxidation, little research has been conducted in this area and this requires further study.

Research on cell senescence has primarily been undertaken on fibroblasts and more research is required to explore whether the same phenomena are observed in cell-types linked to age-related disease such as in senescent adipocytes, pancreatic beta cells, renal proximal tubular epithelial cells and vascular endothelial cells. Whilst different types of senescent cells may share similarities in lipid metabolism, there may also be differences that are cell type-dependent or due to the mechanism of senescence induction and these require further study to better assess the role of altered lipid metabolism during ageing and disease. Finally, an important question to contemplate is whether the alterations in ROS, lipid metabolism and mitochondrial lipids observed during ageing and diseases are due solely to the presence of senescent cells or whether lipidomic changes can occur in absence of senescent cell accumulation.

In recent times, scientific findings on cellular senescence have made headlines. The majority of these highly publicized articles are concerned with the potential health benefits of removing senescent cells from our bodies. Destroying senescent cells in mice can reverse aspects of ageing and prevent side effects in response to chemotherapy.

In an attempt to simplify the term "cell senescence" for public consumption, the media incorrectly use words such as "old", "aged" and "elderly" to describe such cells. This is understandable since "senescence" means "to grow old".

The term "senescence" regarding cells was first used over fifty years ago to describe cells that could no longer proliferate after extended time in culture. Without our current understandings, this inability to proliferate was thought to be due to processes related to cell ageing and so such cells were labelled as "senescent". Although now inaccurate, this labeling is still in use today.

So what is the difference between cell "ageing" and cell "senescence"?

Cell ageing results from the accumulation of random damage leading to impairment in cell function with time. Cell ageing may result from the build up of damage to cellular lipids (i.e. peroxidation), damage to proteins leading to altered protein folding and aggregation, damage to the mitochondria resulting in abnormal metabolic processes and changes (epigenetic) to DNA causing alterations in gene expression.

In contrast to cell ageing, cell senescence is a programmed change in cell state often initiated by persistent damage to DNA.

Although the initial factors which trigger DNA damage in cells may itself be random, the accompanying cellular changes associated with cell senescence are not random. In an orchestrated response,cells permanently stop dividing, they secrete molecules that can attract immune cells and express immune proteins on their cell surface. As such, cell senescence can be considered as a mechanism to eliminate unwanted cells by the immune system.

Part of the reason why senescent cells stay in our bodies and promote ageing may be due to a failure in the ability of an aged immune system to kill senescent cells. The molecules that were once beneficial in attracting immune cells now become destructive over time.

Further scientific evidence demonstrating that senescent cells are not "aged" cells but rather a programmed change in cell state, comes from studies on embryonic development.

Two back to back publications in Cell from 2013 demonstrated that the change in cell state associated with senescent cells may be beneficial during embryonic development. If this indeed the case, it is highly unlikely that such cells suddenly become "aged" or "old" to carry out their function. Embryonic development is highly a regulated process. What is more likely is that such senescent cells are indeed programmed and like programmed cell death (apoptosis), play an important role in tissue remodeling during embryonic development.

Telomere shortening: adding further to the confusion

The vast majority of the early studies on cell senescence were focused on cells which stopped dividing after extended proliferation in culture. This was later shown to be due to telomere shortening.

Every time a cell divides it loses a portion of DNA at the end of its chromosomes called telomeres- long repeats of non-coding DNA. Telomeres protect the ends of our DNA, but when they become too short, they can no longer perform this task. This causes the cell to recognize unprotected DNA-ends as damage. A result of this DNA damage signal is induction of cell senescence.

Throughout our lives, cells divide and our telomeres gradually become shorter. There have been numerous studies investigating the correlation between telomere length and chronological age. In parallel to telomere shortening, gradual random alterations associated with cell ageing will also occur.

This relationship between age, telomere length and cell senescence is likely another explanation for why senescent cells are often thought of as "aged" or "old" cells. But even in this instance, cell senescence does not occur gradually over time like ageing cells, but suddenly in response to a very short telomere.

There is little or no evidence suggesting that telomere shortening per se causes ageing. Cells likely function perfectly well with progressively shorter telomeres. Problems only arise when a telomere eventually becomes too short. As such, telomere shortening increases our risk of age-related conditions as cells are more likely to become senescent.

Drugs which could extend the length of telomeres by activating an enzyme called telomerase (which adds lost telomeres back to DNA) could prevent cells from becoming senescent and help prevent ageing.

In summary, cell ageing can be considered as a unprogrammed, random process leading to a gradual decline in cell function. Cell ageing is detrimental to the function of normal biological processes. Cell senescence can be induced randomly, but is a programmed change in cell state that can occur independent of age. Cell senescence can be both detrimental and beneficial depending on the biological context.

Imagine a world where you could take just a single pill for the treatment or prevention of several age-related diseases. Although still in the realms of science fiction, accumulating scientific data now suggests that despite their biological differences a variety of these diseases share a common cause: senescent cells. This has led scientists to find drugs that can destroy these cells.

When cells become damaged, they either self-destruct (apoptosis) or they lose their ability to grow and remain stuck within the body. These are the non-growing senescent cells that no longer carry out their tasks properly. They spew out chemicals that cause damage to cells nearby, sometimes turning them into “zombies” – hence why they are sometimes referred to as “zombie cells”. Eventually, the damage builds up so much that the function of bodily organs and tissues, such as skin and muscle, becomes impaired. At this point, we identify the changes as disease.

In 2011 and in 2016, researchers at the Mayo Clinic in the US showed, through the use of genetically engineered (transgenic) mice, that the removal of senescent cells reduced cancer formation, delayed ageing and protected the mice against age-related diseases. The mice also lived 25% longer, on average. A similar result in humans would mean an increase in life expectancy from 80 years to 100 years. It was proof-of-principle studies like these that laid the groundwork and inspired other researchers to build on these findings.

Killing a few to save the many

It is not known how many senescent cells need to be present to cause damage to the body, but the harmful effects of the chemicals they release can spread quickly. A few zombie cells may have a huge impact. Drugs for specifically killing senescent cells in order to extinguish their destructive force have recently been revealed and tested on mice. The collective term for these drugs is “senolytics”.

In 2016, two research groups independently published findings on the discovery of two new senolytic drugs which target proteins responsible for protecting senescent cells from cell death. Research lead by scientists from the University of Arkansas, US, showed that the drug ABT-263 (Navitoclax) could selectively kill senescent cells in mice, making aged tissues young again. And scientists from the Weizmann Institute of Science in Israel used the drug ABT-737 to kill senescent cells in the lungs and skin of mice.

There has also been a lot of interest in the role of senescent cells in pulmonary diseases caused by damage to the lungs. Among the risk factors, smoking is known to speed up lung ageing and disease, partly by attacking healthy cells with toxic chemicals from cigarette smoke which can result in cells becoming senescent.

In late 2016, Japanese scientists showed that the removal of senescent cells using genetically engineered mice greatly restored lung function in old mice. A more recent study, lead by scientists at the Mayo Clinic in the US, showed that idiopathic pulmonary fibrosis (scarring of the lungs) was linked to an increase in the number of senescent cells and the damaging effects of the chemicals they release. The killing of senescent cells using genetically engineered mice again greatly improved lung function. In the same study, this group also reported the possible use of a combination of drugs, dasatinib and quercetin, to destroy senescent cells.

A study published earlier this month from the University of Arkansas, extended their previous findings on the drug ABT-263 to pulmonary fibrosis. They found that ABT-263 treatment reduced the problems caused by senescent cells and reversed the disease in mice.

There’s money in senolytics

In light of these accumulating and highly promising findings, a number of start-up biotechnology companies have been created to exploit the health benefits of targeting senescent cells. Probably the most well funded is Unity Biotechnology in the US which raised US$116m for research and development.

It will likely be several years before we see senolytic drugs being tested on humans. If you can’t wait that long, exercise may be the answer. A study published in March 2016 by the Mayo Clinic showed that exercise prevented the accumulation of senescent cells caused by a high-fat diet in mice. So if the regular health benefits of exercise were not enough to get you off the sofa, maybe the anti-ageing benefits will be.